Asthma symptoms and diagnosis in children

What is asthma?

Asthma is a chronic inflammatory disease that causes inflammation in the airways, leading to recurring symptoms, airflow obstruction, and spasms in the bronchi, the airways in the lugs. It's a common condition in children, with a considerable impact on health. Some children outgrow asthma or see a decrease in symptoms as they age. For others, asthma persists into adulthood.

Causes of asthma in children

• Genetic predisposition: Family history of asthma or allergies.
• Viral respiratory infections: The common cold and other respiratory infections can trigger asthmatic symptoms.
• Exposure to allergens: Dust mites, pet dander, pollen, and other environmental allergens can trigger asthma symptoms.
• Environmental pollutants: Tobacco smoke, air pollution, and mold can trigger asthma symptoms.
• Obesity: Excess fat tissue can reduce lung volume and impact airway mechanics and obesity can contribute to inflammation in the body.
• Early-life microbial exposures: The composition and maturation of the gut and airway microbiomes during infancy plays an important role in shaping the immune system. Disruptions in this process, known as microbial dysbiosis, can increase the risk of asthma in children.

Signs and symptoms of asthma

• Wheezing.
• Coughing, especially at night or early morning.
• Shortness of breath.
• Chest tightness.
• Difficulty breathing.
• Increased respiratory rate.
• Fatigue during physical activity.

Asthma triggers

Asthma symptoms can occur at any time, but certain triggers can worsen asthma in children, including:

• Viral infections.
• Environmental allergens.
• Exercise.
• Cold air.
• Tobacco smoke.
• Air pollution.
• Strong odors or fumes.
• Stress.

Asthma attack

During an asthma attack, the airways tighten, become inflamed, and produce extra mucus, making it harder to breathe.The symptoms of an asthma attack include:

• Wheezing: A high-pitched whistling sound made while breathing, particularly during exhalation.
• Shortness of breath: Difficulty in breathing or feeling breathless.
• Chest tightness: A sensation of pressure or constriction in the chest.
• Coughing: Persistent cough, which may be worse at night or early in the morning.
• Increased respiratory rate: Rapid breathing as the body attempts to get more oxygen.
• Use of accessory muscles: Visible effort in breathing, such as the use of neck and shoulder muscles.
• Difficulty speaking: In severe cases, the patient may have trouble speaking in full sentences due to breathlessness.

Asthma diagnosis

Diagnosing asthma in children involves a detailed history, physical examination, and lung function tests for children aged 5+ years. Diagnosis in younger children is based on symptom patterns and therapeutic responses.

Asthma treatment

Asthma is a chronic disease. To keep your child's symptoms under control, certain treatments must be routinely administered.

• Bronchodilators to open the airways and relax the muscles around the bronchi. These work rapidly, and are used during acute asthma symptoms, like wheezing.
• Inhaled steroids possess anti-inflammatory properties and serve as effective daily medications for preventing asthma exacerbations.
• Oral or injection forms of steroids are usually used in clinical settings for acute asthma exacerbations.

These medications can be administered via different delivery methods, like inhalers or nebulizers. Inhalers are portable, and can deliver the medication in a fine mist or powder form. Because inhalers usually require some level of coordination to use appropriately, nebulizers are often used for infants and young toddlers.

Follow-up care

A child with asthma needs regular check-ups to:

• Assess asthma control, including inhaler techniques, treatment adherence, and device maintenance.
• Discuss triggers and how to manage them.
• Talk about any related health conditions, if relevant.

When to consult a pediatrician

A pediatrician should be consulted if:

• Asthma symptoms worsen or become more frequent
• Child frequently requires medications like bronchodilators
• If your child went to urgent care or required hospitalization for asthma symptoms.
• Adverse effects from medications.
• New triggers or comorbid conditions are identified.

Reach out to your local or Summer Health pediatrician if you have any questions about your child’s asthma diagnosis or symptoms.